The cumulative effects of intravenous antibiotic treatments on hearing in patients with cystic fibrosis

被引:75
作者
Garinis, Angela C. [1 ,2 ]
Cross, Campbell P. [1 ,5 ]
Srikanth, Priya [6 ]
Carroll, Kelly [1 ]
Feeney, M. Patrick [1 ,2 ]
Keefe, Douglas H. [3 ]
Hunter, Lisa L. [4 ]
Putterman, Daniel B. [1 ,2 ]
Cohen, Daid M. [7 ]
Gold, Jeffrey A. [8 ]
Steyger, Peter S. [1 ]
机构
[1] Oregon Hlth & Sci Univ, Otolaryngol, Portland, OR 97201 USA
[2] VA Portland Hlth Care Syst, Natl Ctr Rehabil Auditory Res, Portland, OR USA
[3] Boys Town Natl Res Hosp, Omaha, NE 68131 USA
[4] Cincinnati Childrens Hosp, Cincinnati, OH USA
[5] Oregon Hlth & Sci Univ, Sch Med, Portland, OR 97201 USA
[6] Oregon Hlth & Sci Univ, Publ Hlth & Prevent Med, Portland, OR 97201 USA
[7] Oregon Hlth & Sci Univ, Nephrol, Portland, OR 97201 USA
[8] Oregon Hlth & Sci Univ, Pulmonol, Portland, OR 97201 USA
基金
美国国家卫生研究院;
关键词
PATIENTS RECEIVING AMINOGLYCOSIDES; OTOACOUSTIC EMISSIONS; REFERENCE THRESHOLDS; AUDITORY TOXICITY; RISK-FACTORS; OTOTOXICITY; TOBRAMYCIN; THERAPY; COCHLEOTOXICITY; NEPHROTOXICITY;
D O I
10.1016/j.jcf.2017.01.006
中图分类号
R56 [呼吸系及胸部疾病];
学科分类号
摘要
Background: Aminoglycosides (AGs) and glycopeptides are antibiotics essential for treating life-threatening respiratory infections in patients with cystic fibrosis (CF). The goal of this study was to examine the effects of cumulative intravenous (IV)-AG (amikacin and/or tobramycin) and/or glycopeptide (vancomycin) dosing on hearing status in patients with CF. Methods: Hearing thresholds were measured from 0.25 to 16.0 kHz, in 81 participants with CF. Participants were categorized into two groups: normal hearing in both ears (<= 25 dB HL for all frequency bands) or hearing loss (>25 dB HL for any frequency band in either ear). Participants were also characterized into quartiles by their cumulative IV-AG (with or without vancomycin) exposure. Dosing was calculated using two strategies: (i) total number of lifetime doses, and (ii) total number of lifetime doses while accounting for the total doses per day. This was referred to as the "weighted" method. Results: Participants in the hearing loss group were significantly older than those in the normal-hearing group. After adjusting for gender and age at the time of hearing test, participants in the two highest-quartile exposure groups were almost 5 X more likely to have permanent sensorineural hearing loss than those in the two lowest-quartile exposure groups. There was a small group of CF patients who had normal hearing despite high exposure to IV-antibiotics. Conclusions: Cumulative IV-antibiotic dosing has a significant negative effect on hearing sensitivity in patients with CF, when controlling for age and gender effects. A trend for increasing odds of hearing loss was associated with increasing cumulative IV-antibiotic dosing. (C) 2017 European Cystic Fibrosis Society. Published by Elsevier B.V. All rights reserved.
引用
收藏
页码:401 / 409
页数:9
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